Bondi Junction stabbings: Joel Cauchi’s psychiatrist was belligerent and confrontational when giving evidence, inquest told

The psychiatrist who weaned Joel Cauchi from his schizophrenia medication displayed an “exceptional level of belligerence and confrontation” when she gave “confusing” evidence to the Bondi Junction stabbings inquest, a court has heard. Cauchi, 40, killed Ashlee Good, 38, Jade Young, 47, Yixuan Cheng, 27, Pikria Darchia, 55, Dawn Singleton, 25, and Faraz Tahir, 30, and injured 10 others at Westfield Bondi Junction on 13 April 2024 before he was shot and killed by police inspector Amy Scott. Final submissions were made at the New South Wales coroners court on Tuesday, with the senior counsel assisting the inquest, Dr Peggy Dwyer SC, asking: “Why did Joel Cauchi perpetrate the attack, how did he get so unwell, and were there opportunities to prevent his decline into psychosis?” Sign up: AU Breaking News email Dwyer revisited evidence given in May by Cauchi’s former psychiatrist, Dr Andrea Boros-Lavack. At one point, the Toowoomba-based doctor sensationally told the court during the five-week hearing that she believed Cauchi’s attack had “nothing to do with psychosis” before she withdrew those comments the next day. Related: Cauchi’s mass murders put harsh spotlight on failings of mental health and police systems The conjecture was regrettable, given it was widely reported and further traumatised the families of those murdered by Cauchi, Dwyer said on Tuesday. In the course of her testimony, Boros-Lavack displayed an “exceptional level of belligerence and confrontation” in the witness box, was combative and failed to accept responsibility for deficiencies, the counsel assisting said. At times, her evidence was “frankly confusing” and incorrect, Dwyer told the court. “Her initial denial does her no favours” and “her defensive response” reflected a lack of insight, she said. Cauchi’s diagnosis of first episode psychosis by Boros-Lavack was “at best misconceived” and more likely “disingenuous”, experts had determined. She had justified her decision to remove Cauchi from medication by claiming he no longer experienced symptoms of his illness, the court heard on Tuesday. Further, Boros-Lavack did not appear to understand Cauchi’s risk of relapse, Dwyer suggested. It was unanimously accepted by experts that Cauchi was experiencing acute psychosis at the time of the attack and that his behaviour was utterly inconsistent with the person he was when he was well, Dwyer said. In a written submission, Boros-Lavack accepted that her handover of Cauchi to his GP was deficient. The health regulator had the opportunity to investigate the psychiatrist further, Dwyer suggested. She said family submissions would call for Boros-Lavack – who was in a position of “great trust” and “enormous responsibility” – to be referred to a professional panel. “No one could have foreseen the tragic events of 13 April; it’s not suggested that Dr Boros-Lavack could have,” she added. Dwyer said the failure to respond to Cauchi’s own concerns around his mental health, particularly his fears around his obsession with porn, was “extremely sad”. “Joel Cauchi had hopes and dreams for his life and his parents had hopes and dreams for his life.” The court heard earlier on Tuesday that significant reform of the mental health sector was needed to keep people safe. In May, the inquest into the seven deaths heard how the “extremely unwell” Cauchi slipped through the healthcare net in Queensland and stopped taking medication for his schizophrenia five years earlier. Cauchi, who was homeless at the time of the attack, developed a fixation on violence, knives and serial killers, and with some “rudimentary planning”, inflicted a mass stabbing similar to those he had searched for online. Dwyer said that in both Queensland and NSW there was a serious lack of adequate community-based treatments and housing for people who were seriously mentally ill. “It’s not a political statement to say that we need significant investment in those areas to keep people safe,” she told the court. As a stark example of the inadequacy of the current services, she said in 1991, there were about 1,150 short-stay beds in four main inner-city hostels in Sydney. People who were homeless could eat, sleep and receive psychiatric care and onward services in those hostels. Today, there were fewer than 300 temporary beds, and walk-up psychiatric care was only available at two sites in Sydney. “That is a finite problem that is fixable,” she said. Dwyer said defects in the mental health system reached back to the 1960s, when deinstitutionalisation began, shifting mental health policy and service provision away from asylums towards services delivered in community settings. She suggested NSW Health should act as the lead agency advising the government on the decline in mental health services and lead major reform of the area. “It is imperative that this results in action, not just another report,” Dwyer said. Building housing for homeless people who were mentally unwell would save money in the long term and reduce the risk to the community, she said. It was “not a stretch” to say that if those people could be accommodated, it would alleviate the strain on police. Dwyer said bravery decorations were recommended for a number of those involved, including Scott, Good and French bystanders Silas Despreaux and Damien Guerot.